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Doctor Drama: Medical humanities professor advises two TV shows

May 8, 2009

Doctor Drama: Medical humanities professor advises two TV shows

Hershey, Pa. -- When Dan Shapiro came to Penn State Hershey in September 2008, the practicing clinical psychologist also brought with him two television shows. Shapiro, chair of the College of Medicine's humanities department and the Arnold P. Gold Professor of Medical Humanism, is a consultant for the popular ABC television medical dramas "Grey's Anatomy" and "Private Practice."

Shapiro and one of his television collaborators, writer Elizabeth Klaviter, will speak at noon on Tuesday, May 12, in the auditorium of the Hershey Medical Center on the topic of "Public Health and the Television Medical Drama." Klaviter is former director of medical research for "Grey's Anatomy" and recently was promoted to writer for its spinoff series, "Private Practice."

During the talk -- the culmination of a yearlong series of public seminars for medical students, faculty and staff -- Shapiro and Klaviter plan to discuss the progression of a story concept for television, from the moment the idea about a given character is conceived through the writing process and review by technical consultants and, ultimately, to the screen. They also hope to differentiate fact and fiction in the media, particularly on the two medical dramas.

"It's very important to me that the mentally ill, in particular get an accurate sense of what a real therapist would do or say in a real situation," Shapiro said. "I want to insure that people in need see how helpful clinicians can be."

As chair of the first humanities department at a United States medical school -- it was one of the College of Medicine's four founding departments in 1967 when medical students were first accepted at Penn State -- Shapiro and his faculty colleagues place emphasis on producing compassionate, caring, humanistic physicians.

"We have in this department a number of physicians who study ethics, a nurse with a doctorate, an English professor, a history professor, and faculty with theatre and poetry interests," explained Shapiro. "All of us are unique. Together we are an interdisciplinary department, and our mission is to be the heart and soul, inspiration and conscience of the institution and the larger medical community."

All of the college's medical students must complete humanities courses as well as home-based patient visits, to observe how patients' illnesses impact their lives and the lives of their families, attending in particular to the struggles they face. Through these curricular requirements “we encourage students to be reflective and analytical – it forces them to combine the two pillars of medicine; science and compassion," said Shapiro.

He has personal reasons for supporting this well-rounded approach to educating doctors. As an undergraduate student at Vassar College, Shapiro was diagnosed with cancer and spent five years in treatment for the disease. He graduated in psychology and film from Vassar before completing his doctoral degree in clinical and health psychology from the University of Florida as well as an internship and fellowship at Harvard Medical School. He maintains research interests in filmmaking as a teaching tool and the role of narrative in education, and one of his areas of expertise as a psychologist is in treating physicians.

Shapiro also is a writer. His first book, "Mom's Marijuana: Life, Love & Beating the Odds," details his experience fighting Hodgkin's disease. But it was his second book that ushered him into the realm of medical dramas. "Delivering Doctor Amelia: The Story of a Gifted Young Obstetrician's Mistake and the Psychologist Who Helped Her" was published in 2004, while Shapiro was associate professor of clinical psychiatry at the University of Arizona College of Medicine.

"My second book made the rounds among members of the medical community, including one of my college classmates at Vassar," he explained. "He put me in contact with writers at 'Grey's Anatomy,' and they came for a talk at Arizona. Six months later, when title character Meredith Grey went into therapy, the writers wanted to make sure show accurately portrayed that type of relationship."

Initially, Shapiro received script scenes late in the writing process. Since then, his role has evolved, especially since one of the main characters on "Private Practice," Violet Turner (played by Amy Brenneman) is a therapist.

"Now the writers may give me a situation and say, 'We need X, Y and Z to happen in a scene. At the end the character's arc is this. What kind of patient would fit that, how would they be treated?' Sometimes I will receive early version of scripts with amusing dialogue placeholders that say, 'What's the medical? We should give him a medical medical,' It has helped that I have a background in writing as well as in psychology," he explained.

Of course, he noted, there are physicians who write for the show, and the entire writing team is medically sophisticated.

"The writers are very respectful of the language; they understand that words are the therapist's scalpel," he said. "They may not always agree with me, but I feel I have very thoughtful colleagues at both shows."

Shapiro has never been on the set of either show; he consults via telephone and e-mail. Writers send him files of scripts. "I talk with the show's director of research and writers, and less frequently I talk with actors," he said. "In fact, I will be meeting Elizabeth Klaviter in person for the first time this week."

Recently, both shows have seen story arcs with psychological issues as central themes. Last year on "Grey's Anatomy," a patient (Jane Doe/Rebecca/Ava, played by Elizabeth Reaser) who initially presented herself as a pregnant amnesiac accident victim gradually evolved into a recurring character with a personality disorder.

"I spoke with the actress about that role because the character's development was complicated," said Shapiro. "The character had a fairly complex presentation of symptoms."

Most recently, the season cliffhanger on "Private Practice" ends with a female therapy patient who came to therapist Violet's home and is threatening the doctor's life. And while Shapiro won't discuss a central "Grey's Anatomy" plotline involving character Isobel "Izzie" Stevens (played by Katherine Heigl), a doctor presumed to be dying of cancer, it seems that Shapiro's personal experience coping with the disease could be a helpful resource to the writers.

However involved his consulting work may be or seem to be, he still considers it a hobby.

"My administrative assistant wants to meet McDreamy (neurosurgeon Derek Shepherd, played by Patrick Dempsey). I enjoy the entertainment aspect of it," he said. "They named a walk-on character after me last year, which was fun. When Ava walked into an examining room, one character said, 'This is Dr. Shapiro, he's going to evaluate you now.' While fun, it doesn't define me or my career. To the extent that I can use it as a vehicle to educate the public about other issues that I care about, I want to do that.

"Mental health is rising in its prevalence across the media. I think as a society we are coming to terms both with our past and how we will invest to adequately meet our nation’s needs in the future," added Shapiro. "My goal as a consultant has been to make sure that the mentally ill aren't always portrayed as violent, that their needs and treatments are accurately portrayed. These shows are brilliant storytelling vehicles, and at ABC I feel that I have strong colleagues who are trying to portray these issues fairly on the air."